A retrospective study on the potential of 99m Tc-HDP imaging before therapy for individualizing treatments with 223 Ra-Cl2 for metastatic castration resistant prostate cancer.

PURPOSE: Research on dose-effect correlation is necessary to move toward an individualization of treatments of metastatic castration resistant prostate cancer (mCRPC) with 223 Ra-Cl2 . We first looked for a possible correlation of 99m Tc-HDP lesion uptake in pretreatment whole-body scans (WBSs) with lesion absorbed dose. Moreover, we looked for a possible correlation of 99m Tc-HDP lesion uptake in pretreatment WBSs and of lesion absorbed dose with relative change in the 99m Tc-HDP lesion uptake obtained from pre- and post-treatment WBSs in patients treated for mCRPC with six cycles of 223 Ra-Cl2 . METHODS: Eleven patients received six cycles of 55 kBq/kg of 223 Ra-Cl2 separated by 4 weeks. In addition, one patient received concomitant treatment with abiraterone and two patients with enzalutamide. The 99m Tc-HDP WBSs were acquired before the first cycle and after the sixth cycle of the treatment. For the lesions with the higher 99m Tc-HDP uptake, the absorbed dose was calculated for the first cycle. Lesion volume was determined from 99m Tc-HDP SPECT/CT images before the first cycle and 223 Ra-Cl2 activity in the lesions was determined from 223 Ra-Cl2 planar images after the first cycle. The effect of the treatment was evaluated from the relative change of the mean and the maximum counts in the lesions, both estimated from the WBSs acquired before the first cycle and after the sixth cycle. RESULTS: The absorbed dose was calculated for 30 lesions, with values ranging between 0.4 and 3.8 Gy (mean 1.5 Gy). A significant (P < 0.05) high positive linear correlation was found between the lesion absorbed dose in the first treatment cycle and the mean and maximum counts in the lesions in the WBSs acquired before the first cycle (R = 0.75 and 0.76, respectively). The relative change of the mean and the maximum counts in the lesions in the 99m Tc-HDP WBSs showed a significant (P < 0.05) high positive logarithmic correlation with the 99m Tc-HDP mean and maximum counts in the lesions before the first cycle (R = 0.79 and 0.78, respectively). Lastly, a significant (P < 0.05) high positive logarithmic correlation was also found between the relative change of the mean and the maximum counts in the lesions in the 99m Tc-HDP WBSs and the lesion absorbed dose (R = 0.86 and 0.85, respectively). For this correlation the influence of the administered activity and of the concomitant treatments was not found to be significant (P > 0.05). CONCLUSIONS: The high correlations found for the 99m Tc-HDP lesion uptake before the first cycle lesion with the relative change in the 99m Tc-HDP lesion uptake after the six cycles of 223 Ra-Cl2 , and with the lesion absorbed dose in the first cycle show the potential of pretreatment 99m Tc-HDP imaging in order to personalize the performance of these treatments.

Australian vegetated coastal ecosystems as global hotspots for climate change mitigation.

Policies aiming to preserve vegetated coastal ecosystems (VCE; tidal marshes, mangroves and seagrasses) to mitigate greenhouse gas emissions require national assessments of blue carbon resources. Here, we present organic carbon (C) storage in VCE across Australian climate regions and estimate potential annual CO2 emission benefits of VCE conservation and restoration. Australia contributes 5-11% of the C stored in VCE globally (70-185 Tg C in aboveground biomass, and 1,055-1,540 Tg C in the upper 1 m of soils). Potential CO2 emissions from current VCE losses are estimated at 2.1-3.1 Tg CO2-e yr-1, increasing annual CO2 emissions from land use change in Australia by 12-21%. This assessment, the most comprehensive for any nation to-date, demonstrates the potential of conservation and restoration of VCE to underpin national policy development for reducing greenhouse gas emissions.

Experiencia autorreferida en pacientes tratados con antivirales directos frente al virus de la hepatitis C / Self-reported experience in patients treated with Hepatitis C direct acting antivirals

Introducción y objetivo: Conocer y analizar la experiencia autorreferida del tratamiento de los pacientes VHC que iniciaron tratamiento con agentes antivirales directos (AAD), a tiempo real, de forma proactiva e integrada en el proceso asistencial de atención farmacéutica. Material y métodos: Estudio observacional y transversal desarrollado entre abril (inicio del Plan Estratégico Nacional) y diciembre de 2015 en la Consulta Externa del Servicio de Farmacia. Se utilizó como herramienta un cuestionario prospectivo cumplimentado por los pacientes donde se recogieron variables relacionadas con la calidad de vida vinculadas con la salud (CVRS), adherencia, efectos adversos (EA), satisfacción con el tratamiento, y valoración y utilidad del programa formativo implementado por el Servicio de Farmacia. Se realizó un análisis descriptivo de todas las variables incluidas en el estudio y se analizó la influencia de las diferentes variables en el grado de adherencia y CVRS. El análisis de las diferencias entre los dos grupos se realizó mediante el test de chi cuadrado y el cálculo de las OR con un modelo de regresión logística simple. Se utilizó el programa SPSS® versión 20, y se estableció una significación estadística para valores de p < 0,05. Resultados: Se recogieron155 encuestas de las 226 enviadas, tasa de respuesta del 68,6%.En referencia a la CVRS (valoración del estado físico y emocional), un 38,7% de los pacientes refieren que su estado físico y emocional es mucho mejor desde el inicio del tratamiento. La presencia de EA y una peor información global de su enfermedad se asoció con un peor estado físico y emocional (p < 0,05). La adherencia reportada fue del 84,5% y el tratamiento fue valorado como muy bueno o bueno por el 87% de los pacientes. Un 52,9% de los pacientes no tuvieron efectos adversos relacionados con la medicación y el proceso formativo realizado por el farmacéutico especialista en la primera consulta fue valorado por el 96,7% de los pacientes como muy bueno o bueno. Conclusiones: La experiencia autorreferida obtenida a través de un contacto directo y permanente con los pacientes permite obtener información sobre aspectos importantes del tratamiento. Creemos que estas herramientas deben incorporarse a los procedimientos de atención farmacéutica como una forma de mantener la continuidad. Además, inducen al paciente a una autoevaluación de diversos aspectos de su propio tratamiento, que pueden ayudar a conseguir una mayor implicación en el mismo y contribuir a conseguir el máximo resultado en salud posible de la farmacoterapia (AU)

Background and objective: To learn about and analyze the self-reported treatment experience of HCV patients who started treatment with direct acting antivirals agents (DAA), at a real-time, proactive and integrated into the pharmaceutical care healthcare process, using a prospective questionnaire completed by patients as clinical tool. Material and methods: Observational and cross-sectional study conducted between April (start of the National Strategic Plan) and December 2015 in the Outpatient Pharmacy Service. The questionnaire includes variables related to health related quality of life (HRQOL), adherence, adverse effects (AEs), satisfaction, and usefulness of the Pharmacy Service implemented training program. A descriptive analysis of all variables included in the study was conducted and the influence of different variables analyzed in the degree of adherence and HRQOL. The analysis of the differences was performed using chi-square test and simple logistic regression model for calculation of OR. We use SPSS version 20 program and statistical significance for values of p < 0.05 was considered. Results: 155 of the 226 surveys returned, with a response rate of 68.6%. Referring to the HRQOL (evaluation of physical and emotional state), 38.7% of patients reports that their physical and emotional state is much better from the start of treatment. The presence of EA and worse global information of their disease was associated with worse physical and emotional state (p < 0.05). Reported adherence was 84.5% and the treatment was evaluated as very good or good by 87% of patients. 52.9% had no adverse effects related to the medication and the training process performed by the specialist pharmacist at the first visit 96.7% of patients assessed as very good or good. Conclusions: Self-reported experience acquired through direct and constant contact with patients provides information on important aspects of treatment. We believe that these tools should be incorporated into pharmaceutical care procedures as a way to maintain continuity in patients direct contact. They also induce patients to a self-assessment of various aspects of their own treatment, which can help achieve greater involvement in it and can contribute to achieve the maximum health outcome in pharmacotherapy (AU)

[Self-reported experience in patients treated with Hepatitis C direct acting antivirals]. / Experiencia autorreferida en pacientes tratados con antivirales directos frente al virus de la hepatitis C.

BACKGROUND AND OBJECTIVE: To learn about and analyze the self-reported treatment experience of HCV patients who started treatment with direct acting antivirals agents (DAA), at a real-time, proactive and integrated into the pharmaceutical care healthcare process, using a prospective questionnaire completed by patients as clinical tool. MATERIAL AND METHODS: Observational and cross-sectional study conducted between April (start of the National Strategic Plan) and December 2015 in the Outpatient Pharmacy Service. The questionnaire includes variables related to health related quality of life (HRQOL), adherence, adverse effects (AEs), satisfaction, and usefulness of the Pharmacy Service implemented training program. A descriptive analysis of all variables included in the study was conducted and the influence of different variables analyzed in the degree of adherence and HRQOL. The analysis of the differences was performed using chi-square test and simple logistic regression model for calculation of OR. We use SPSS version 20 program and statistical significance for values of p < 0.05 was considered. RESULTS: 155 of the 226 surveys returned, with a response rate of 68.6%. Referring to the HRQOL (evaluation of physical and emotional state), 38.7% of patients reports that their physical and emotional state is much better from the start of treatment. The presence of EA and worse global information of their disease was associated with worse physical and emotional state (p < 0.05). Reported adherence was 84.5% and the treatment was evaluated as very good or good by 87% of patients. 52.9% had no adverse effects related to the medication and the training process performed by the specialist pharmacist at the first visit 96.7% of patients assessed as very good or good. CONCLUSIONS: Self-reported experience acquired through direct and constant contact with patients provides information on important aspects of treatment. We believe that these tools should be incorporated into pharmaceutical care procedures as a way to maintain continuity in patients direct contact. They also induce patients to a self-assessment of various aspects of their own treatment, which can help achieve greater involvement in it and can contribute to achieve the maximum health outcome in pharmacotherapy.

Introducción y objetivo: Conocer y analizar la experiencia autorreferida del tratamiento de los pacientes VHC que iniciaron tratamiento con agentes antivirales directos (AAD), a tiempo real, de forma proactiva e integrada en el proceso asistencial de atención farmacéutica. Material y métodos: Estudio observacional y transversal desarrollado entre abril (inicio del Plan Estratégico Nacional) y diciembre de 2015 en la Consulta Externa del Servicio de Farmacia. Se utilizó como herramienta un cuestionario prospectivo cumplimentado por los pacientes donde se recogieron variables relacionadas con la calidad de vida vinculadas con la salud (CVRS), adherencia, efectos adversos (EA), satisfacción con el tratamiento, y valoración y utilidad del programa formativo implementado por el Servicio de Farmacia. Se realizó un análisis descriptivo de todas las variables incluidas en el estudio y se analizó la influencia de las diferentes variables en el grado de adherencia y CVRS. El análisis de las diferencias entre los dos grupos se realizó mediante el test de chi cuadrado y el cálculo de las OR con un modelo de regresión logística simple. Se utilizó el programa SPSS® versión 20, y se estableció una significación estadística para valores de p < 0,05. Resultados: Se recogieron155 encuestas de las 226 enviadas, tasa de respuesta del 68,6%.En referencia a la CVRS (valoración del estado físico y emocional), un 38,7% de los pacientes refieren que su estado físico y emocional es mucho mejor desde el inicio del tratamiento. La presencia de EA y una peor información global de su enfermedad se asoció con un peor estado físico y emocional (p < 0,05). La adherencia reportada fue del 84,5% y el tratamiento fue valorado como muy bueno o bueno por el 87% de los pacientes. Un 52,9% de los pacientes no tuvieron efectos adversos relacionados con la medicación y el proceso formativo realizado por el farmacéutico especialista en la primera consulta fue valorado por el 96,7% de los pacientes como muy bueno o bueno. Conclusiones: La experiencia autorreferida obtenida a través de un contacto directo y permanente con los pacientes permite obtener información sobre aspectos importantes del tratamiento. Creemos que estas herramientas deben incorporarse a los procedimientos de atención farmacéutica como una forma de mantener la continuidad. Además, inducen al paciente a una autoevaluación de diversos aspectos de su propio tratamiento, que pueden ayudar a conseguir una mayor implicación en el mismo y contribuir a conseguir el máximo resultado en salud posible de la farmacoterapia.

[Risk prevention evaluation in the incorporation of new drugs for healthcare practices: a methodological proposal]. / Evaluación preventiva de riesgos en la incorporación de nuevos medicamentos a la práctica asistencial: una propuesta metodológica.

OBJECTIVE: Submit a preventive assessment methodology for the risk of medication errors when incorporating new drugs in clinical practice as well as a description of the types of actions arising from such action. MATERIALS AND METHODS: A Standard Operating Procedure was established which defines and plans the process of assessing the risks of new drugs purchased by the Pharmacy Services before being incorporated into the distribution and dispensation channels. The pharmacist responsible for each area fills the Risk Assessment Form, a questionnaire that facilitates the analysis of the product characteristics and provides guidance on safety measures to be taken depending on the results of that assessment. If it is confirmed that the drug requires some additional security measures to be taken, all professionals and technical staff of the Pharmacy Services shall be informed of measures to be taken. RESULTS: Between 2011 and 2013, 64 drugs were assessed. 35 of them (54.6%) required some additional security measure to be applied before being incorporated into clinical practice. CONCLUSIONS: The implementation of the method of preventive risk assessment for new drugs purchased by the Pharmacy Services can be a very useful tool when taking the measures deemed necessary to minimize the likelihood of a medication error occurring before they are incorporated into the distribution/dispensing channels put in place by the Pharmacy Services.

Evaluación preventiva de riesgos en la incorporación de nuevos medicamentos a la práctica asistencial: una propuesta metodológica / Risk prevention evaluation in the incorporation of new drugs for healthcare practices: a methodological proposal

Objetivo: Presentar una metodología de evaluación preventiva de riesgos de errores de medicación en la incorporación de nuevos medicamentos a la práctica asistencial, así como una descripción de las acciones derivadas de dicha actuación. Material y métodos: Se estableció un Procedimiento Normalizado de trabajo que define el proceso de evaluación de riesgos de los nuevos medicamentos adquiridos por el Servicio de Farmacia antes de ser incorpora la Ficha de Evaluación de Riesgos, cuestionario que facilita el análisis delas características del medicamento y orienta sobre las medidas de seguridad que se deben adoptar en función de los resultados. Resultados: Se evaluaron 64 medicamentos. En 35 (54,6%) se aplicó alguna medida preventiva de seguridad: incorporación a la Guía de Administración de medicamentos por sonda nasogástrica (3 fármacos), aplicación de la instrucción Técnica de cambio de concentración/presentación segura (7), incorporación al listado de medicamentos que contienen Látex (3), remisión de notas informativas a los profesionales sanitarios (12), adopción de medidas para almacenamiento seguro (6), incorporación de material educativo en los folletos informativos para pacientes externos (12), incorporación de interacciones farmacológicas a la base de datos (2), inicio de procedimiento de resolución de expediente (1) y comunicación a la AEMPS de errores potenciales por similitud de envases (2). Conclusiones: La implantación de esta evaluación preventiva de riesgos puede resultar una herramienta muy útil a la hora de tomar las medidas para minimizar la probabilidad de que se produzca un error de medicación, antes de que se incorpore a los circuitos de distribución/dispensación

Objective: Submit a preventive assessment methodology for the risk of medication errors when incorporating new drugs in clinical practice as well as a description of the types of actions arising from such action. Materials and methods: A Standard Operating Procedure was established which defines and plans the process of assessing the risks of new drugs purchased by the Pharmacy Services before being incorporated into the distribution and dispensation channels. The pharmacist responsible for each area fills the Risk Assessment Form, a questionnaire that facilitates the analysis of the product characteristics and provides guidance on safety measures to be taken depending on the results of that assessment. If it is confirmed that the drug requires some additional security measures to be taken, all professionals and technical staff of the Pharmacy Services shall be informed of measures to be taken. Results: Between 2011 and 2013, 64 drugs were assessed. 35of them (54.6%) required some additional security measure t be applied before being incorporated into clinical practice. Conclusions: The implementation of the method of preventive risk assessment for new drugs purchased by the Pharmacy Services before being incorporated into the distribution and dispensationchannels. The pharmacist responsible for each area fills the RiskAssessment Form, a questionnaire that facilitates the analysisof the product characteristics and provides guidance on safetymeasures to be taken depending on the results of that assessment. If it is confirmed that the drug requires some additionalsecurity measures to be taken, all professionals and technicalstaff of the Pharmacy Services shall be informed of measuresto be taken. Results: Between 2011 and 2013, 64 drugs were assessed. 35of them (54.6%) required some additional security measure tobe applied before being incorporated into clinical practice. Conclusions:The implementation of the method of preventiverisk assessment for new drugs purchased by the Pharmacy Services can be a very useful tool when taking the measures dee-med necessary to minimize the likelihood of a medication erroroccurring before they are incorporated into the distribution/dis-pensing channels put in place by the Pharmacy Services

Desarrollo, implantación y evaluación de un programa de prescripción electrónica asistida de medicamentos en un hospital / Development, implementation and evaluation of an electronic drug prescribing program in a hospital

Objetivo: Desarrollar e implantar herramientas seguras y eficaces para la prescripción electrónica de los tratamientos farmacológicos. Material y método: Se realizó una revisión bibliográfica para cada medicamento o principio activo incluido en la Guía Farmacoterapéutica del Hospital para recoger información acerca de sus interacciones y ajustes posológicos en insuficiencia renal. Se elaboró una base de datos con 62 interacciones clínicamente relevantes y otra de 531 fármacos con recomendaciones posológicas o de monitorización en función del grado de insuficiencia renal (IR). Resultados: La integración de la base de datos de IR permite que desde el Servicio de Farmacia se pueda seleccionar a los pacientes con alteración en la función renal que tienen prescritos medicamentos que requieren ajuste posológico y asesorar sobre las recomendaciones individualizadamente, incorporando esta información a la historia clínica electrónica. Conclusión: esta herramienta, ha mejorado el programa de prescripción electrónica, convirtiéndolo en una prescripción electrónica asistida (AU)

Objetive: Develop and implement safe and effective tools for computer provider order entry to serve as clinical decision support. Material and methods: A literature review was performed for each drug included in the Hospital's pharmaceutical guide for collecting information on clinically relevant drug interactions and dose adjustments in renal failure Results: A database with 62 clinically relevant interactions was developed and integrated into the hospital information program. When an interaction is detected at the time of prescribing an alert is generated to report on its consequences and alternatives. Another database with 531 drugs with dosing or monitoring recommendations specific to the degree of renal failure in each patient was developed and integrated into the hospital information system, so that from the Pharmacy Department we can select patients with impaired renal function who have been prescribed drugs that require dose adjustment and advise on the dosage recommendations for each patient. Conclusion: Due to the development and implementation of these tools, we have improved our computer provider order entry with a clinical decision support system (AU)

Meta-análisis sobre la eficacia de la estrategia de monoterapia con inhibidores de la proteasa potenciados en pacientes VIH+ / Meta-analysis of the effectiveness of the strategy of monotherapy with boosted protease inhibitors in HIV+ patients

Introducción El objetivo del presente trabajo es analizar la evidencia disponible sobre la eficacia de la estrategia de inducción mantenimiento con inhibidores de proteasa potenciados con ritonavir en pacientes adultos VIH respecto al tratamiento convencional. Métodos Se realizó un meta-análisis de ensayos aleatorizados y controlados en pacientes VIH para comparar la eficacia de una estrategia de monoterapia con inhibidores de proteasa potenciados frente al tratamiento antirretroviral convencional. La búsqueda bibliográfica se realizó en PubMed, EMBASE (septiembre 1999–septiembre 2009) y en resúmenes de congresos de los últimos 5 años. Se calcularon los Odds Ratio del fracaso terapéutico y sus intervalos de confianza del 95%. Para combinar los resultados de los estudios individuales seleccionados, se empleó un modelo de efectos fijos basado en el método de Mantel-Haenszel o de efectos aleatorios, en función de que exista o no heterogeneidad en los resultados. Resultados Se localizaron inicialmente un total de 1.510 publicaciones, de las que solo 8 estudios cumplieron los criterios de inclusión en el meta-análisis. El Odds Ratio combinado de los 8 estudios es de 1,39 (IC 95% 1,02–1,90) a favor del grupo de tratamiento con tratamiento antirretroviral convencional, pero con un intervalo de confianza cercano a los límites de la no significación estadística. Conclusión Los resultados del análisis de eficacia combinado en el meta-análisis no encuentran diferencias significativas entre la estrategia convencional y la monoterapia. Esta estrategia se considera recomendable (nivel A de evidencia) en pacientes sin historia de fracaso previo a inhibidores de la proteasa, con carga viral plasmática indetectable y signos o síntomas de toxicidad por análogos de nucleósidos/nucleótidos (AU)

Introduction The objective of this study is to analyse the available evidence regarding the effectiveness of the strategy of induction maintenance with boosted protease inhibitors with ritonavir in adult HIV patients as compared to conventional treatment. Methods We performed a meta-analysis of randomised controlled trials in HIV patients to compare the efficacy of a monotherapy strategy of boosted protease inhibitors as compared with conventional antiretroviral therapy. The literature search was conducted in PubMed, EMBASE (September 1999–September 2009) and in conference abstracts of the last 5 years. The Odds Ratio of treatment failure and their 95% confidence intervals were calculated. To combine the results of individual studies selected, a fixed effects model based on the Mantel-Haenszel method or random effects was used, depending on whether or not the results were heterogeneous. Results Initially a total of 1510 publications were found, of which just 8 studies met the criteria for inclusion in the meta-analysis. The combined Odds Ratio of the 8 studies is 1.39 (95% CI 1.02–1.90) for the treatment group with conventional antiretroviral treatment, but with a confidence interval close to the limits of statistical non-significance. Conclusion The results of the combined effectiveness analysis in the meta-analysis found no significant differences between the conventional strategy and monotherapy. This strategy is considered recommended (level A evidence) in patients with no history of previous failure of protease inhibitor, with undetectable plasma viral load and signs or symptoms of nucleoside/nucleotide toxicity (AU)

[Meta-analysis of the effectiveness of the strategy of monotherapy with boosted protease inhibitors in HIV+ patients]. / Meta-análisis sobre la eficacia de la estrategia de monoterapia con inhibidores de la proteasa potenciados en pacientes VIH+

INTRODUCTION: The objective of this study is to analyse the available evidence regarding the effectiveness of the strategy of induction maintenance with boosted protease inhibitors with ritonavir in adult HIV patients as compared to conventional treatment. METHODS: We performed a meta-analysis of randomised controlled trials in HIV patients to compare the efficacy of a monotherapy strategy of boosted protease inhibitors as compared with conventional antiretroviral therapy. The literature search was conducted in PubMed, EMBASE (September 1999-September 2009) and in conference abstracts of the last 5 years. The Odds Ratio of treatment failure and their 95% confidence intervals were calculated. To combine the results of individual studies selected, a fixed effects model based on the Mantel-Haenszel method or random effects was used, depending on whether or not the results were heterogeneous. RESULTS: Initially a total of 1510 publications were found, of which just 8 studies met the criteria for inclusion in the meta-analysis. The combined Odds Ratio of the 8 studies is 1.39 (95% CI 1.02-1.90) for the treatment group with conventional antiretroviral treatment, but with a confidence interval close to the limits of statistical non-significance. CONCLUSION: The results of the combined effectiveness analysis in the meta-analysis found no significant differences between the conventional strategy and monotherapy. This strategy is considered recommended (level A evidence) in patients with no history of previous failure of protease inhibitor, with undetectable plasma viral load and signs or symptoms of nucleoside/nucleotide toxicity.

Aspectos farmacoeconómicos de la monoterapia con lopinavir potenciado con ritonavir / Pharmacoeconomic aspects of lopinavir/ritonavir monotherapy

El presente artículo revisa, de forma breve, cuáles son los principales tipos de análisis farmacoeconómico como base para reflexionar sobre el análisis de los costes asociados a la infección por el virus de la inmunodeficiencia humana, así como evaluar el grado de eficiencia del tratamiento antirretroviral en general. Asimismo, se presentan los resultados de diferentes análisis farmacoeconómicos aplicados a la selección de antirretrovirales en diferentes escenarios clínicos de tratamiento. Finalmente, se realiza un análisis de las ventajas, en términos de eficiencia, que tiene la estrategia de inducción-mantenimiento basada en lopinavir potenciado con ritonavir, tanto en el ahorro de costes directos asociados al tratamiento, como en la posible disminución de los costes derivados del tratamiento de efectos adversos de los análogos de los nucleósidos(AU)

The present article briefly reviews the main types of pharmacoeconomic analyses that evaluate the costs associated with HIV infection and the efficiency of antiretroviral therapy in general. The results of several pharmacoeconomic analyses applied to the selection of antiretroviral drugs in distinct clinical scenarios are also presented. Finally, we analyze the advantages, in terms of efficiency, of lopinavir/ritonavir as induction-maintenance therapy, both in terms of saving the direct costs of treatment and in possibly reducing the costs due to the management of the adverse effects of nucleoside analogs(AU)

[Pharmacoeconomic aspects of lopinavir/ritonavir monotherapy]. / Aspectos farmacoeconómicos de la monoterapia con lopinavir potenciado con ritonavir.

The present article briefly reviews the main types of pharmacoeconomic analyses that evaluate the costs associated with HIV infection and the efficiency of antiretroviral therapy in general. The results of several pharmacoeconomic analyses applied to the selection of antiretroviral drugs in distinct clinical scenarios are also presented. Finally, we analyze the advantages, in terms of efficiency, of lopinavir/ritonavir as induction-maintenance therapy, both in terms of saving the direct costs of treatment and in possibly reducing the costs due to the management of the adverse effects of nucleoside analogs.